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Charter Healthcare · 5 months ago

Compliance Contract Manager

Rancho Cucamonga, CA

Contract

Onsite

Senior Level

5+ years exp

Charter Healthcare is seeking a Compliance Contract Manager to oversee the development, negotiation, and maintenance of various contracts. The role involves collaborating with the sales team and internal departments to ensure compliance and support sales growth through new and existing contracts.

Health CareMedical

Responsibilities

Develop, negotiate, and maintain contracts with all contracting entities, e.g., insurance companies, MSOs, IPAs, TPAs, vendors and government programs. This includes researching territories to identify gaps with our payer base and supporting the expansion into new markets

Lead and manage the contracting team

Actively participate in establishing strategic business goals with the Leadership team

Assure contractual arrangements meet financial targets and legal/regulatory compliance requirements. There will be an emphasis on analyzing cost and utilization data

Facilitate the approval process of all contract documents from pre-contract through post-signature phases

Responsible for the accuracy of supporting documentation for contracts and completing documents accurately

Develop and maintain processes that provide timely notification of critical contract events (e.g., renewals, termination and due dates contained within the agreements)

Maintain existing relationships with contracted providers. Ensure contractual language is kept current; evaluate fee schedule on a yearly basis to identify possible opportunities for additional covered services, medical policy changes and reimbursement

Coordinate and communicate contractual terms to the billing department; ensure staff is informed of changes in medical policy and binning policies

Conduct on-going assessments of assigned networks and make recommendations for strategic initiatives, goals, and objectives

Develop and maintain periodic reports on the status of all contracts

Assure accurate data entry of contract specifications and terms into database and completeness of all contracting processes

Maintain excellent written and verbal communication with all internal and external customers

Assist with all contracting administration and projects, as needed

All other duties and responsibilities as assigned

Qualification

Contract negotiationHealthcare industry knowledgePayor contracting relationshipsAnalytical skillsLeadership experienceOrganizational skillsComputer software proficiencyInterpersonal skillsCommunication skills